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Dark-Blood Delayed-Enhancement MRI of Myocardial Infarction
- Publication Year :
- 2017
-
Abstract
- This study introduced and validated a novel flow-independent delayed enhancement technique that shows hyperenhanced myocardium while simultaneously suppressing blood-pool signal.The diagnosis and assessment of myocardial infarction (MI) is crucial in determining clinical management and prognosis. Although delayed enhancement cardiac magnetic resonance (DE-CMR) is an in vivo reference standard for imaging MI, an important limitation is poor delineation between hyperenhanced myocardium and bright LV cavity blood-pool, which may cause many infarcts to become invisible.A canine model with pathology as the reference standard was used for validation (n = 22). Patients with MI and normal controls were studied to ascertain clinical performance (n = 31).In canines, the flow-independent dark-blood delayed enhancement (FIDDLE) technique was superior to conventional DE-CMR for the detection of MI, with higher sensitivity (96% vs. 85%, respectively; p = 0.002) and accuracy (95% vs. 87%, respectively; p = 0.01) and with similar specificity (92% vs, 92%, respectively; p = 1.0). In infarcts that were identified by both techniques, the entire length of the endocardial border between infarcted myocardium and adjacent blood-pool was visualized in 33% for DE-CMR compared with 100% for FIDDLE. There was better agreement for FIDDLE-measured infarct size than for DE-CMR infarct size (95% limits-of-agreement, 2.1% vs. 5.5%, respectively; p 0.0001). In patients, findings were similar. FIDDLE demonstrated higher accuracy for diagnosis of MI than DE-CMR (100% [95% confidence interval [CI]: 89% to 100%] vs. 84% [95% CI: 66% to 95%], respectively; p = 0.03).The study introduced and validated a novel CMR technique that improves the discrimination of the border between infarcted myocardium and adjacent blood-pool. This dark-blood technique provides diagnostic performance that is superior to that of the current in vivo reference standard for the imaging diagnosis of MI.
- Subjects :
- Adult
medicine.medical_specialty
Magnetic Resonance Spectroscopy
Myocardial Infarction
Contrast Media
Pilot Projects
Delayed enhancement
030204 cardiovascular system & hematology
Article
030218 nuclear medicine & medical imaging
03 medical and health sciences
Young Adult
0302 clinical medicine
Text mining
Dogs
Predictive Value of Tests
Internal medicine
Coronary Circulation
medicine
Organometallic Compounds
Imaging diagnosis
Animals
Humans
Radiology, Nuclear Medicine and imaging
cardiovascular diseases
Myocardial infarction
Aged
Tissue Survival
business.industry
Myocardium
Clinical performance
Reproducibility of Results
Heart
Middle Aged
medicine.disease
Infarct size
Prognosis
Magnetic Resonance Imaging
Disease Models, Animal
Case-Control Studies
Dark blood
cardiovascular system
Cardiology
Cardiology and Cardiovascular Medicine
business
Cardiac magnetic resonance
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Accession number :
- edsair.doi.dedup.....0b28ca367a84d657229ef08cb6c2189f